As I’m sure many of you are aware, the US Preventive Services Task Force issued new recommendations yesterday regarding regular mammograms for breast cancer screenings. Among their recommendations are the following:

The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take into account patient context, including the patient’s values regarding specific benefits and harms.
The USPSTF recommends biennial screening mammography for women between the ages of 50 and 74 years. (Grade B recommendation)
The USPSTF recommends against clinicians teaching women how to perform breast self-examination. (Grade D recommendation)

For women like myself who were brought up to think that early detection saves lives, these guidelines are hard to accept. At first I was comforted by reading that they don’t apply to women in high-risk groups. Then I learned that the high-risk group only included women “at increased risk for breast cancer by virtue of a known underlying genetic mutation or a history of chest radiation.” Again, having been taught early on that a strong family history of breast cancer (even without the known genetic mutation) puts one in a higher-risk category, I was shocked to learn that even these people might be counseled to follow the new recommendations. So then I took a closer look at their reasoning.

Turns out the guidelines are based on the idea that routine mammograms for women in their forties (and yearly versus biennial mammograms for women in their fifties) can actually do more harm than good. In their words, “the USPSTF reasoned that the additional benefit gained by starting screening at age 40 years rather than at age 50 years is small, and that moderate harms from screening remain at any age.” So we’re looking at “small” vs. “moderate” here. These “moderate harms” include “psychological harms, unnecessary imaging tests and biopsies in women without cancer, and inconvenience due to false-positive screening results.” They also determined that the number of lives saved by early screening is not enough to counterbalance these harmful effects. For women in their forties, one life is saved for 1904 women screened; for women in their fifties, one life is saved for 1339 women screened. This boils down to a 15% and 14% risk reduction, respectively.

Ok- I am by no means an expert, but I can tell you that I would much rather undergo the “inconvenience of a false-positive,” or what turns out to be an unnecessary biopsy, rather than die of a tumor that could have been detected, had I only found the lump via a self exam or went in for a mammogram at age 48.  I realize that the financial costs (in addition to the psychological costs) of unnecessary imaging tests and biopsies are high, and that one life saved for every 1904 women screened is a very small number.  But, when that one life saved turns to be your mother, or your wife, or your best friend- or YOU- it seems a lot bigger, doesn’t it?

For the past two weeks I have been vexed by an ad on the 151 CTA bus I take to work everyday. It features puzzle- a pie with eight pieces, each of which contain a number. Two of these numbers are missing, and it’s the viewer’s job to figure out what they’re supposed to be.

The reason this ad bothered me so much is because the answer was not written upside down on the bottom of the poster, as one might hope. Instead, you have to go to Marbles the Brain Store and ask an associate (which makes sense, from a marketing perspective). So, this past Friday night, I was very excited to happen upon a Marbles in the new wing of Old Orchard Mall in Skokie.

The bad news: I was not at all correct. The good news? (Read more…)

Responding to a firestorm of criticism, Kellogg’s claim that eating Cocoa Rice Krispies will “support” your immune system has been withdrawn.  In a press release posted yesterday, the company announced it would, “…discontinue the immunity statements on Kellogg’s Rice Krispies cereals.”

Oddly, Kellogg’s maintains that, “…science shows that these antioxidants help support the immune system.” I sent them a note last week, requesting literature citations supporting this position. No reponse yet.

Nurition and health expert Marion Nestle has been blogging about the Krispie fiasco, and even has a letter from the San Francisco City Attorney, demanding evidence for the immunity claim.

While at my family’s breakfast table over the weekend, a Kellogg’s Cocoa Krispies box caught my eye.  “Now helps support your child’s immunity,”  the box blares.  On the back, Snap, Crackle, and Pop are in superhero form – masks, fighting poses and all.

The trouble is, the claim is not supported by any real scientific evidence.  Yes, vitamins and antioxidants in natural foods like fresh fruits and vegetables are part of a healthy diet. But exactly what role vitamin-fortified foods play in helping your immune cells fight disease is not understood. (Read more…)

A followup to the blog entry of 9/10/09.

While home with the flu yesterday, I watched several episodes of Discovery Channel’s Cash Cab – the surprisingly entertaining show where unsuspecting New York cab riders are invited to participate in a quiz show (and win cash) while riding in a cab to their destination.

Almost every “ride” featured a basic science/health trivia question.  A sampling:

1. In 1953, scientists Watson and rick discovered that DNA takes what unique shape? (Read more…)

The ability to do math has long been thought of as a purely human trait – it comes with the whole higher-intelligence thing. But what if the ability to do math wasn’t as restricted to our makeup as we thought? Are we really as special as we think we are, or is our ego much larger than our reality?

Recent studies are turning up mathematical abilities in many different species of animals. Chickens, bees, and of course monkeys have all shown promise in being able to deal with simple mathematical operations, like differentiating between numbers, counting, and summing. The animals are performing math linguistically like we do – they are not physically counting out objects or identifying numbers. Rather, it is some sort of innate ability constituting rough math. (Read more…)

Every day I want to learn something new. Today, what I learned was not only new, but also involved very cool science. I was catching up on listening to some podcasts and I heard a story about a guy named Michael Musnick. Mr. Musnick was described in the story as a “citizen scientist” who lives in Duchess County, New York. With no formal training, he wrote a grant to study wood turtles in the Great Swamp in Duchess County. He wanted to study the turtles because he had the time to do so and, in his own words, he thought the turtles were cute.

His study involved attaching radio transmitters to the shells of wood turtles. During his studies, he observed and counted dead wood turtles on a set of railroad tracks. New York’s Metropolitan Transportation Authority has a train rail running right through the area he was studying. What he discovered was that the dead wood turtles were not being killed by passing trains, but were getting stuck between the rails and were dying from the summer heat. On his own, he came up with a solution….turtle bridges. What the heck is that? Click here and take a look at the video.

So, today I learned what a turtle bridge looks like and what purpose it serves. But the thing I find really cool about this story is that a private citizen had an idea to study something in the world around him, discovered something new, and came up with a simple solution to a problem. It makes me want to run out and look more closely at the world around me. Is there something that I’ve seen before but never thought deeply enough about to allow me to see how I can lend a hand? How about you, reader? If you look more closely at the world today, will you spot something new? Let me know!

The 2009 Nobel Prize in Physiology or Medicine was awarded on Monday to three American scientists: Elizabeth H. Blackburn (University of California, San Francisco), Carol W. Greider (Johns Hopkins University), and Jack W. Szostak (Harvard). The three discovered telomeres, short sequences of DNA at the end of each chromosome that act as a protective cap, helping to limit how many times a cell can divide. This New York Times article has a nice description of telomeres and the broader significance of this work for cancer therapies and aging research.

So how much federal funding was invested in this Nobel Award?  According to the National Institutes of Health, approximately $32 million between the three researchers. To the average reader, this sure sounds like a lot. But when you consider that an average 4-year research grant to support a small lab can easily total $1.5 million, and many labs have two or more, it’s actually a bargain.

It’s also worth pointing out that the economic burden of cancer illness and deaths in 2004 alone was nearly $200 billion.

The recognition that telomeres play an important role in aging and cancer – which was not foreseen – serves as yet another reminder why research dollars invested in “basic research” are dollars invested wisely.

As an aside, every time I think of telomeres I recall one of my favorite Saturday Night Live skits, “Stand Up and Win.” It’s the one featuring Jerry Seinfeld as M.C. of a game show. The winner receives a year’s supply of the plastic thingies that protect the ends of shoelaces. Seinfeld exclaims, “They don’t have a name!”

This morning, I was speaking to a friend who works for the Minnesota Department of Public Health.  His job there involves HIV/AIDS testing, awareness, and education programming for the Minneapolis area.  He told me an interesting fact.  In Minneapolis, over the past year there has been a 100% increase in the number of HIV infections among people tested in his clinic.  When I asked him if the number of people being tested had increased during the same testing period, I expected him to say, “Yes.”  One could argue, therefore, that the increase in HIV(+) people being tested was not truly a 100% increase.  I was surprised and dismayed when he responded that the number of people being tested was actually smaller than the previous reporting period.  If the number of cases doubled over the previous year but the number of people being tested was actually lower, what does that mean?  My friend, Charlie, and I simultaneously said over the phone, “What the heck is going on in Minneapolis?” (Read more…)